后循环脑梗死患者的预后分析

Prognostic analysis of patients with posterior circulation cerebral infarction

目的评估后循环脑梗死患者的预后并分析影响预后的相关因素。方法对274例经头颅MRI确诊且资料完整的后循环脑梗死(PCCI)患者进行随访,评估残障量表(mRS)、Barthel指数(BI)以了解患者的预后情况,并分析预后相关因素。结果 274例后循环梗死患者中,无残障或轻度残障(mRS0～3分)占87.6%,严重残障(mRS4～5分)占9.9%,死亡占2.6%。mRS评估的多因素回归分析显示发病至就诊时间、入院时美国国立卫生院卒中量表(NIHSS)评分、既往卒中史、高同型半胱氨酸(Hcy)(P<0.05)与预后相关。结论后循环梗死患者的总体预后良好,病死率低。发病至就诊时间长、入院时NIHSS评分高、既往有卒中史者、伴高同型半胱氨酸血症者预后不良。

Objective To assess the prognosis of patients with posterior circulation cerebral infarction（PCCI） and analyze the risk factors of the prognosis. Methods To analyze the 274 patients with PCCI in our hospital. All patients were confirmed with the ischemic area in the posterior circulation on admission by head MRI. We performed modified rankin scale （mRS） and Barthel index （BI） assessments for all patients for understanding the patient＇ s prognosis and evaluating the risk factors. Results Of the 274 patients,87. 6% showed no or mild disability（ MRS 0-3 ） and 9.9% showed severe disability（ MRS 4-5 ）. Mortality was 2.6% of all the patients. Multiple regression analysis of MRS assessment showed that onset to treatment time, admission national institutes of health stroke scale （NIHSS） score, stroke history, high homocysteine （Hcy） （P 〈 0.05） were associated with the prognosis. Conclusions The majority of PCCI patients have good prognosis with the low mortality rate. The prognosis is good in those patients without high Hcy, stroke history, and with low NIHSS score and being treated timely.